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Pulmonology

Dupilumab shows promise in patients with type 2 asthma with elevated neutrophil counts

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Dupilumab, when used as an add-on treatment, significantly reduces severe asthma exacerbations and improves lung function in patients with uncontrolled, moderate-to-severe type 2 asthma, according to a study.

This positive effect was observed regardless of the baseline blood neutrophil count, indicating that dupilumab may be an effective treatment option for a broad range of patients with this type of asthma.

This post hoc analysis from the Phase 3 LIBERTY ASTHMA QUEST trial investigated the efficacy of dupilumab in patients with type 2 asthma enrolled in QUEST, with or without elevated blood neutrophil counts. The study assessed annualized severe exacerbation rates over a 52-week treatment period, as well as the least-squares mean change from baseline in forced expiratory volume in 1 s (FEV1) over time. Patients were categorized based on their baseline type 2 biomarkers (blood eosinophils ≥ 150 cells/µL or fractional exhaled nitric oxide (FeNO) ≥ 20 ppb) and low (<4,000 cells/µL) or high (≥4,000 cells/µL) neutrophil counts.

The analysis demonstrated that dupilumab significantly reduced annualized severe exacerbation rates compared to placebo across all subgroups of patients with elevated type 2 biomarkers, regardless of their baseline neutrophil count. Notably, improvements in FEV1 were observed as early as Week 2 and were sustained over the 52-week treatment period, irrespective of baseline neutrophil count. Safety findings were consistent across all subgroups, irrespective of neutrophil counts at baseline.

Reference

Bleecker ER, Panettieri RA Jr, Lugogo NL, et al. Dupilumab Efficacy in Patients with Type 2 Asthma with and without Elevated Blood Neutrophils. J Immunol Res. 2023;2023:9943584. doi: 10.1155/2023/9943584. PMID: 37901346; PMCID: PMC10602700.

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